Navajo pharmacist fills patient education gap

TSAILE, Ariz. — Some people enter the twilight years of college without a clue of what they want to do, only to decide at the last minute. Others, like pharmacist Terry Teller, know early on.

For Teller, a member of the Navajo Native American tribe originally from Lukachukai, Ariz., helping to heal people is part of his heritage, with multiple generations of medicine men and women on both sides of his family.

Teller had several healthcare-related jobs, including research and working as a nurse’s aid. He considered medical school before working with a pharmacist at an Indian Health Service facility in Tsaile, Ariz., which inspired him to go to pharmacy school at the University of New Mexico, where he earned his doctor of pharmacy degree in 2007.

“From all of those, I found I really didn’t want to do the direct patient care a doctor would provide,” Teller told Drug Store News. He now divides his time between work as a staff pharmacist at Tsaile and as a weekend relief pharmacist at Walmart stores in Farmington and Gallup, N.M.

At Walmart, Teller often finds himself using a skill uncommon among pharmacists: his ability to speak the Navajo language, which his parents speak and he studied in high school and college. As the only pharmacist in his area who speaks the language, he’s often in high demand, particularly among elderly customers. “Once they know I speak Navajo, once they know I can explain things, I get held up on the floor for a while,” Teller said.

One issue that accompanies speaking in a different language is cultural attitudes. “One of the challenges is having [the customers] understand that these medications will work, because there is a struggle to tell them, especially if they’re very traditional in thought. A lot of them have the mindset that they need a ceremony, and their high blood pressure or blindness will disappear,” Teller said, noting that patients often will attend ceremonies and use traditional herbal remedies, creating a need to consult references to Navajo herbal medicines and online databases to prevent potential drug interactions.

Another issue is the way illness is discussed in Navajo culture. Teller can’t tell a patient directly that he or she has a disease and will encounter certain symptoms, but instead must frame it in indirect terms, such as saying that if “a person” had a disease, he or she might encounter this or that symptom. “If I tell them [directly], in the traditional Navajo mindset, it’s like cursing them,” Teller said.

According to the Centers for Disease Control and Prevention, Native Americans and Alaska Natives have the highest rates of diabetes in the 10- to 19-year-old age category. Apache County, where Lukachukai is located, and neighboring McKinley County, N.M., have diabetes prevalence rates greater than 10.6%, according to the CDC.

Most diabetes patients strive to keep their A1c levels below 7%, but Teller sometimes encounters patients with levels of 14%. Heart disease rates among Native Americans and Alaska Natives also are among the highest in the country, with the CDC reporting hypertension rates of 28% and high cholesterol rates of 30%.

Any program working to reduce those rates requires public awareness, but that’s part of what got Teller into pharmacy in the first place. “For me, why I wanted to get into pharmacy was that I didn’t like direct patient care, but where I get a lot of my enjoyment is with patient education,” he said.

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